No-fault auto insurance bill touted by Gov. Rick Scott has major gap

Posted by on May 1, 2012 | 0 comments

By Charles Elmore and John Kennedy

Palm Beach Post Staff Writers

TALLAHASSEE — In their haste to meet one of Gov. Rick Scott’s top priorities, Florida lawmakers left a glaring, potentially multimillion-dollar pothole in legislation revamping the state’s no-fault auto insurance.

Scott had called the bill recasting the state’s fraud-filled personal injury protection system one of the biggest accomplishments of the 2012 session, which ended last month.

Just last week, in signing the state’s $69.9 billion budget, Scott’s devotion to the measure was clear. He lectured elementary school youngsters on the value of reforming PIP, even though the kids were barely out of car seats.

“There’s money that’s wasted in auto accident mistakes, fraud,” Scott told children at the budget-signing in a St. Johns County elementary school. “So we passed a bill – personal injury protection – that hopefully will reduce the growth rate and the cost of auto accident fraud.”

Scott has until May 5 to sign the bill, which was received in his office April 20.

But the bill that cuts massage therapists and others out of the payment loop may need some massaging itself. The bill (HB 119) contains a six-month gap in eligibility for health care professionals that might allow insurance companies not to pay some PIP providers such as doctors, chiropractors, medical schools and dentists, those familiar with the issue say.

Major insurers say they are prepared to treat health providers fairly, but acknowledged they don’t speak for every carrier.

“For that period it’s conceivable the billing process could be adversely affected,” said Michael Carlson, executive director of the Personal Insurance Federation of Florida, whose charter members include State Farm, Allstate and Progressive.

Insurers, health providers and others have met with state insurance officials in recent weeks about the issue, which escaped the attention of industry, regulators, legislators and staff, Carlson said.

The bill, passed in the waning hours of the session, marks the latest attempt to overhaul the state’s $10,000 PIP coverage required since the 1970s. The system, intended to reduce lawsuits and get payments to injured drivers quickly in minor accidents, has been plagued by frequent complaints about fraud, staged accidents and high premiums.

Scott’s office did not respond to questions about options that are believed to include an emergency rule granting certain providers PIP eligibility for six months, or a letter of intent from legislators or the governor.

The state’s Agency for Health Care Administration “is making preparations to clarify confusion that may exist should the governor sign the bill into law,” AHCA spokeswoman Meagan Dougherty said. AHCA officials declined to offer details.

Florida Hospital Association General Counsel Bill Bell said his group has been involved in discussions about the issue, but he does not see a legal problem reimbursing qualified PIP providers.

“If there is any clarifying statement, that’s up to the agencies that are affected,” Bell said.

Behind the scenes, other lobbyists say the problem is that the legislation erases on July 1 a number of professionals now eligible for PIP reimbursement and later in the bill revives that eligibility for certain providers on Jan. 1, 2013. The gap raises the question of whether insurers could be exempt from paying claims to some of those treating PIP patients.

Any loose ends or confusion about the law may not be a good thing in an industry considered rife with wholesale fraud.

Call it a fender-bender for a headline reform effort on the road to becoming law

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